[Safety and effectiveness of emergency stenting for acute anterior circulation large artery disease].

Objective: To explore the safety and effectiveness of early stent implantation in patients with acute anterior circulation large artery disease. Methods: Patients were recruited from the RESCUE-RE study (a registration study for Critical Care of Acute Ischemic Stroke After Recanalization). Patients who were diagnosed with acute ischemic stroke within 24 hours of onset and given endovascular treatment after consultation from July 2018 to May 2019 from 18 sub-centers nationwide were retrospectively enrolled. According to whether the stents were placed during the operation, the patients were divided into two groups: stenting group and non-stenting group. The baseline between the two groups was matched by propensity score. The matching variables included age, sex, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline Glasgow Coma Scale (GCS) score, history of stroke, smoking and onset to hospital time. The primary clinical outcome was 90-day good neurological outcome [defined as modified Rankin score (mRS) 0-2]. Secondary outcomes include 90-day mortality, 24-hour re-occlusion of the responsible artery, and symptomatic intracranial hemorrhage. The differences in clinical endpoints between the two groups were compared. Result: A total of 899 patients with acute anterior circulation artery stenosis or occlusion were included in the study, with a mean age of(66±12)years,and 532(59.18%) were male. There were 193 patients in the stenting group and 706 patients in the non-stenting group. After the baseline data between the two groups were matched by propensity score, 169 patients were enrolled in each of two groups respectively. After matching, the proportion of patients in the stenting group with etiological diagnosis of large atherosclerosis [82.53% (137/166) vs 55.69% (93/167)] and the proportion of patients with previous history of hypertension [63.31% (107/169) vs 47.93% (81/169)] in the stenting group were higher than those in the non-stenting group (both P<0.05). While the proportion of patients in the non-stenting group with cardiogenic embolism [37.73%(63/167) vs 11.45%(19/166)]and the proportion of patients with atrial fibrillation [18.93% (32/169) vs 10.65%(18/169)]was higher(all P<0.05). In the stenting group, the time from onset to recanalization was longer[519 (408, 620)min vs 469 (365, 690)min], and the proportion of general anesthesia [50.89% (86/169) vs 35.50% (60/169)] was higher in the stenting group(both P<0.05). In addition, in the stenting group, the proportion of patients receiving mechanical thrombectomy[67.46% (114/169) vs 88.76% (150/169)] and arterial thrombolysis [2.37% (4/169) vs 18.93% (32/169)] was lower than non-stenting group during the operation, while the proportion of patients receiving balloon dilation [53.85% (91/169) vs 13.61% (23/169)]was higher(both P<0.05). The proportion of patients in stent group receiving antiplatelet drugs before operation was higher [13.46% (21/169) vs 8.70% (14/169)](both P<0.05). In terms of clinical outcome, compared with the non-stenting group, the proportion of patients in the stenting group with good neurological function in 90 days was lower [44.79% (73/169) vs 56.36% (93/169)], and the proportion of death at 90 days was higher[15.98% (27/169) vs 8.88% (15/169)] (both P<0.05). There was no significant difference between the two groups in 24-hour re-occlusion[8.88% (15/169) vs 9.47% (16/169)] and symptomatic intracranial hemorrhage[5.92% (10/169) vs 4.76% (8/169)](both P>0.05). Conclusion: For patients with acute anterior circulation artery disease, early stent therapy may increase the proportion of patients with adverse neurological outcomes.

[Interventional effect of metformin on pulmonary inflammation and pulmonary fibrosis in silicotic rats].

Objective: To investigate the interventional effect of metformin on pulmonary inflammation and pulmonary fibrosis in silicotic rats. Methods: In April 2019, 48 Wistar male rats of SPF grade were randomly divided into negative control group, metformin control group, silicon dioxide (SiO2) model group, low, medium and high dose metformin intervention group according to the random number table method, 8 rats in each group. The SiO2 model group and the low, medium and high dose metformin intervention groups were given 1 ml 50 mg/ml of SiO2 by intratracheal instillation, the negative control group and the metformin control group were given 1 ml normal saline by intratracheal instillation. 24 hours later, the low, medium and high dose metformin intervention groups and the metformin control group were treated with 100, 200, 400 and 400 mg/kg metformin daily, the control and SiO2 model groups received normal saline daily. Then the rats were sacrificed at the 28th day after SiO2 exposure. The changes of rat body weight and pathological examination of rat lung tissue were observed, and the lung organ coefficient, the content of hydroxyproline (HYP) , the expression levels of inflammatory factors transforming growth factor beta1 (TGF-ß1) , tumor necrosis factor-alpha (TNF-α) , interleukin-1beta (IL-1ß) and the protein expression of E-cadherin (E-Cad) , Vimentin, α-SMA were detected. Results: Compared with the negative control group, SiO2 model group had a significant decrease in the body weight of rats (P<0.05) , lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-ß1, TNF-α, IL-1ß were all significantly increased (P<0.05) . Compared with the SiO2 model group, the weights of the rats in the medium and high dose intervention group of metformin increased significantly (P<0.05) . And after intervention with different doses of metformin, the lung organ coefficient, alveolitis and fibrosis scores, HYP content and the levels of TGF-ß1, TNF-α and IL-1ß were significantly decreased (P<0.05) . Immunohistochemistry and Western blotting results showed that compared with the negative control group, the expression of E-Cad of the SiO2 model group was decreased, and the expression levels of Vimentin and α-SMA were significantly increased (P<0.05) . After metformin intervention, the expression of E-Cad was significantly increased, the expression levels of Vimentin and α-SMA were significantly decreased (P<0.05) . Conclusion: Metformin can reduce lung tissue inflammation and fibrosis in rats exposed to SiO2 dust, which may be related to reducing the expression of inflammatory factors in lung tissue and inhibiting the EMT process.

[Association studies between postoperative hypoeosinophilia and hospital stay in patients undergoing hip fracture surgery under different anesthesia].

Objective: To investigate early postoperative changes in eosinophils (EOS) and the relationship of postoperative hospital stay and hypoeosinophilia in patients undergoing hip fracture surgery under general or spinal anesthesia. Methods: The clinical data of patients who underwent hip fracture surgery at Beijing Tiantan Hospital between April 2014 and November 2017 were retrospectively analyzed. Patients were classified according to whether they received general anesthesia or spinal anesthesia. Univariate regression analysis was used to examine a number of covariates potentially contributed to postoperative hospital stay. Multivariate linear regression was used to analyze the relationship between postoperative day 1 EOS counts and postoperative hospital stay. Interaction and stratified analyses were conducted according to anesthesia methods. Results: A total of 149 patients were included in this study. Thirty-four of them underwent general anesthesia and 115 of them underwent spinal anesthesia. The postoperative day 1 EOS of the general anesthesia group was 0 (0,1.8)×107/L, which was lower than that of the spinal anesthesia group 1.0(0,6.0)×107/L (Z=3.095, P<0.01). After adjusting the confounders of age, gender, American Society of Anesthesiologists (ASA) grade, intraoperative blood loss, intraoperative red blood cell (RBC) transfusion, postoperative day 1 hematocrit (HCT) and white blood cell (WBC), postoperative complications, and the interaction terms for ASA, intraoperative blood loss, intraoperative RBC transfusion and postoperative complications, the negative correlation between postoperative hospital stay and postoperative day 1 EOS level was significant (ß=-0.39, 95%CI:-0.74--0.05, P<0.05) in the general anesthesia group. Conclusion: EOS were significantly decreased after surgery in general anesthesia group, and the postoperative hospital stay was negatively correlated with postoperative day 1 hypoeosinophilia.

TUG1 promotes diabetic atherosclerosis by regulating proliferation of endothelial cells via Wnt pathway.

OBJECTIVE: To explore the specific role of TUG1 in regulating the occurrence and progression of diabetic atherosclerosis and its underlying mechanism. PATIENTS AND METHODS: TUG1 expressions in coronary artery disease (CAD) tissues, normal arterial tissues, endothelial cells induced by high-dose glucose and tumor necrosis factor-α (TNF-α) were detected by quantitative Real-time polymerase chain reaction (qRT-PCR). The effects of TUG1 on proliferation, migration and cell cycle of human umbilical vein endothelial cells (HUVECs) were detected by cell counting kit-8 (CCK-8), transwell assay and flow cytometry, respectively. Subsequently, protein expressions of proliferation-related genes, cell cycle-related genes and Wnt pathway-related genes were detected by Western blot after altering TUG1 expression in HUVECs. Further rescue experiments were carried out to explore whether TUG1 could regulate diabetic atherosclerosis via Wnt pathway. RESULTS: Overexpressed TUG1 was found in CAD tissues and endothelial cells induced by high-dose glucose and TNF-α compared with those of controls. TUG1 overexpression remarkably promoted proliferation, migration and cell cycle of HUVECs. Protein expressions of ß-catenin and c-Myc were upregulated by overexpression of TUG1. Rescue experiments indicated that XAV-939, the inhibitor of Wnt pathway, could partially reverse the increased proliferative and migratory changes in HUVECs induced by TUG1 overexpression. CONCLUSIONS: We found that overexpressed TUG1 stimulates proliferation and migration of endothelial cells via Wnt pathway, thereby promoting the occurrence and progression of diabetic atherosclerosis.

Expressions of VEGF and miR-21 in tumor tissues of cervical cancer patients with HPV infection and their relationships with prognosis.

OBJECTIVE: To investigate the expressions of vascular endothelial growth factor (VEGF) and micro-ribonucleic acid-21 (miR-21) in cervical cancer patients with human papillomavirus (HPV) infection and determine the potential relationships with prognosis. PATIENTS AND METHODS: Expressions of VEGF in cervical cancer tissues and cancer-adjacent tissues were detected by immunohistochemistry, and the expressions of miR-21 and VEGF in both tissues were quantitatively analyzed using reverse transcription polymerase chain reaction (RT-PCR). Patients with cervical cancer were followed up after operation, and the survival rates of patients with different expression levels of miR-21 and VEGF were compared. RESULTS: VEGF was expressed in both cervical cancer tissues and cancer-adjacent tissues. The positive expression rate of VEGF in cervical cancer tissues (75.69%) was significantly higher than that in cancer-adjacent tissues (10.45%). RT-PCR results showed that the expression levels of miR-21 and VEGF in cervical cancer tissues were significantly higher than those in cancer-adjacent tissues (p<0.05). Correlation analyses revealed that miR-21 expression was significantly positively correlated with VEGF expression in cervical cancer tissues (r2=0.4174, p<0.0001). Prognostic analyses showed that the 5-year survival rate of patients was relatively high when miR-21 and VEGF were lowly expressed. CONCLUSIONS: VEGF and miR-21 are highly expressed in tumor tissues of cervical cancer patients with HPV infection. VEGF expression is significantly positively correlated with miR-21 expression, and the high levels of VEGF and miR-21 predict unfavorable prognosis of cervical cancer. Data provide a theoretical support for clinical treatment of cervical cancer patients with HPV infection.

CD44v6 expression in patients with stage II or stage III sporadic colorectal cancer is superior to CD44 expression for predicting progression.

BACKGROUND: Currently, it is difficult to predict the prognosis of patients exhibiting stage II or stage III colorectal cancer (CRC) and to identify those patients most likely to benefit from aggressive treatment. The current study was performed to examine the clinicopathological significance of CD44 and CD44v6 protein expression in these patients. STUDY DESIGN: We retrospectively investigated 187 consecutive patients who underwent surgery with curative intent for stage II to III CRC from 2007 to 2013 in the Beijing Civil Aviation Hospital. CD44 and CD44v6 protein expression levels were determined using immunohistochemistry and compared to the clinicopathological data. RESULTS: Using immunohistochemical detection, CD44 expression was observed in 108 (57.75%) of the CRC patients; and its detection was significantly associated with greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological tumor-lymph node-metastasis (TNM) stage. CD44v6 expression was observed in 135 (72.19%) of the CRC patients; and its expression was significantly associated with a poorly differentiated histology, greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological TNM stage. Expression of CD44v6 was higher than that of CD44 in stage II and stage III sporadic CRC. CONCLUSION: CD44v6 is a more useful marker for predicting a poor prognosis in stage II and stage III sporadic CRC as compared to CD44.

The structure and possible functions of the milkfish Chanos chanos adipose eyelid.

Basic histological sections (with different staining methods) and scanning electron microscopy (SEM) examinations showed that there were three distinctive layers in the adipose eyelid of milkfish Chanos chanos, which is found in the cephalie region and covers the entire eye. The outer and inner layers were epithelial tissues and the middle layer was composed of connective tissue formed by type I collagen fibrils. No adipose tissue was found in any of the three layers of the so-called adipose eyelid. Examination by transmission spectrophotometer showed that the adipose tissue could filter out ambient light with a wavelength shorter than 305 nm. A photoretinoscope was used to investigate whether the adipose eyelid influenced the mechanism of eye focusing. Eye diopter values did not differ before or after eyelid removal, which indicated that the adipose eyelid did not play a role in eye focusing. In light of these findings, it is suggested that the adipose eyelid serves to block exposure of harmful ultraviolet light into eyes and may also to offer some protection against impact to the eye in the aquatic environment.

CDKN2A gene inactivation in epithelial sporadic ovarian cancer.

The tumour suppressor gene CDKN2A, located on chromosome 9p21, encodes the cell cycle regulatory protein p16. Inactivation of the CDKN2A gene could lead to uncontrolled cell growth. In order to determine the role of CDKN2A in the development of sporadic ovarian cancer, loss of heterozygosity at 9p21-22, homozygous deletion, mutation and methylation status of the CDKN2A gene as well as CDKN2A expression were examined in a panel of serous papillary ovarian cancer. The frequency of loss of heterozygosity (LOH) for one or more informative markers at 9p21-22 was 65% (15/23). The most common deleted region was located between interferon (IFN)-alpha and D9S171. Homozygous deletions and mutations of the CDKN2A gene were not found. There was no evidence of methylation in exon 1, but methylation in exon 2 of CDKN2A gene was found in 26% (6/23). Absence of CDKN2A gene expression was shown in 27% (6/22) at mRNA level and 21% (4/19) at protein level. These data suggest that the CDKN2A gene is involved in the tumorigenesis of ovarian cancer, but the mechanisms of CDKN2A gene inactivation in serous papillary ovarian cancer remains unclear.

A comparative study of hearing ability in fishes: the auditory brainstem response approach.

Auditory brainstem response (ABR) techniques, an electrophysiological far-field recording method widely used in clinical evaluation of human hearing, were adapted for fishes to overcome the major limitations of traditional behavioral and electrophysiological methods (e.g., invasive surgery, lengthy training of fishes, etc.) used for fish hearing research. Responses to clicks and tone bursts of different frequencies and amplitudes were recorded with cutaneous electrodes. To evaluate the effectiveness of this method, the auditory sensitivity of a hearing specialist (goldfish, Carassius auratus) and a hearing generalist (oscar, Astronotus ocellatus) was investigated and compared to audiograms obtained through psychophysical methods. The ABRs could be obtained between 100 Hz and 2000 Hz (oscar), and up to 5000 Hz (goldfish). The ABR audiograms are similar to those obtained by behavioral methods in both species. The ABR audiogram of curarized (i.e., Flaxedil-treated) goldfish did not differ significantly from two previously published behavioral curves but was lower than that obtained from uncurarized fish. In the oscar, ABR audiometry resulted in lower thresholds and a larger bandwidth than observed in behavioral tests. Comparison between methods revealed the advantages of this technique: rapid evaluation of hearing in untrained fishes, and no limitations on repeated testing of animals.

Damage and recovery of hair cells in fish canal (but not superficial) neuromasts after gentamicin exposure.

Recent evidence demonstrating the presence of two types of sensory hair cell in the ear of a teleost fish (Astronotus ocellatus, the oscar) indicates that hair cell heterogeneity may exist not only in amniotic vertebrates but also in anamniotes. Here we report that a similar heterogeneity between hair cell types may also occur in the other mechanosensory organ of the oscar, the lateral line. We exposed oscars to the aminoglycoside (ototoxic) antibiotic gentamicin sulfate and found damaged sensory hair cells in one class of the lateral line receptors, the canal neuromasts, but not in the other class, the superficial neuromasts. This effect was not due to the canal environment. Moreover, new ciliary bundles on hair cells of the canal neuromasts were found after, and during, gentamicin exposure. The pattern of hair cell destruction and recovery in canal neuromasts is similar to that of type I-like hair cells found in the striolar region of the utricle and lagena of the oscar after gentamicin treatment. These results suggest that the hair cells in the canal and superficial neuromasts may be similar to type I-like and type II hair cells, respectively, in the fish ear.

Histochemical and immunocytochemical identification of the pituitary cell types in three sciaenid fishes: Atlantic croaker (Micropogonias undulatus), spotted seatrout (Cynoscion nebulosus), and red drum (Sciaenops ocellatus).

The adenohypophysial cell types in three species of sciaenid teleosts were identified using a combination of classical histochemical techniques and immunocytochemistry with antisera raised against piscine and human pituitary hormones. In general greater specificity for the different cell types was observed with antisera to the piscine pituitary hormones than with antisera raised against the human hormones. The distribution of the cell types did not differ significantly among the three species, Atlantic croaker (Micropogonias undulatus), spotted seatrout (Cynoscion nebulosus), and red drum (Sciaenops ocellatus), and was similar to that reported in several other teleosts. A major portion of the rostral pars distalis was composed of acidophilic prolactin cells which showed specific binding to antisera to carp, coho salmon, and chinook salmon prolactins. The acidophilic corticotrops formed cords of cells which bordered the prolactin cells and showed strong immunoreactivity with anti-human ACTH. This antiserum also cross-reacted with the lead hematoxylin-positive cells in the pars intermedia. The acidophilic growth hormone cells were restricted to the dorsal part of the proximal pars distalis in close contact with the neurohypophysis and were specifically bound by anti-carp and anti-chum salmon growth hormone. The basophilic thyrotrops were located in the dorsal-anterior part of the proximal pars distalis and showed strong immunoreactivity to antiserum to the human thyrotropin beta subunit. This antiserum also bound weakly to the basophilic gonadotrops which were concentrated in the ventral part of the proximal pars distalis and also extended posteriorly to form a border around the pars intermedia. Antiserum to croaker maturational gonadotropin, which recognizes two distinct gonadotropins in sciaendis, bound strongly and specifically to the gonadotrops. The gonadotrops were also bound specifically by antisera to the alpha and beta subunits of human luteinizing hormone. Antisera to the beta subunits of two recently isolated coho salmon gonadotropins, GTH-I and GTH-II, failed to bind the gonadotrops strongly or differentially in the three sciaenid species. Consequently, the number of gonadotropin cell types in sciaenid fishes remains unresolved.

Electric organ discharge frequency and plasma sex steroid levels during gonadal recrudescence in a natural population of the weakly electric fish Sternopygus macrurus.

1. Sternopygus macrurus were collected in Venezuela during the period of gonadal recrudescence in early or late dry season. Electric organ discharge (EOD) frequencies were recorded, blood samples were taken for analysis of steroid titers, and gonads were taken for determination of reproductive condition. 2. Mean EOD frequencies were significantly lower in males than in females in all samples. EOD frequency was inversely correlated with body length in males in late, but not early, dry season, and these parameters were never correlated in females. 3. Plasma levels of testosterone (T) and 11-ketotestosterone (11-KT), but not estradiol-17 beta (E2), were inversely correlated with EOD frequency in males. No 11-KT was observed in plasma of females, and plasma levels of T and E2 in females were comparable to those of males. Neither T nor E2 were correlated with EOD frequency in females. 4. Testes collected in late dry season were more mature than those from early dry season; androgen levels and EOD frequency were correlated with testicular maturity. Ovaries collected in early dry season were immature, while those from late dry season were more mature. There was no relationship between EOD frequency and stage of ovarian development. 5. These results suggest that plasma androgens modulate EOD frequency in males during the reproductive season and that plasma E2 has little relationship to EOD frequency in either sex.

Human chorionic gonadotropin-induced shifts in the electrosensory system of the weakly electric fish, Sternopygus.

Sternopygus macrurus of both sexes were injected with human chorionic gonadotropin (hCG) or saline. Electric organ discharge (EOD) frequency rose after hCG injections in females and gradually declined to baseline levels over the next few weeks. EOD changes in males were more complex and variable; most males showed an initial minor rise in EOD frequency followed by a larger decrease, or simply a decrease. hCG treatment also resulted in a rise in electroreceptor best frequency and shortened electric organ pulse duration in females, and had the opposite effect on these parameters in males. The saline-injected controls showed no changes in any of these parameters. Levels of testosterone (T) and 11-ketotestosterone, but not estrogen (E), were elevated in males preceding the fall in EOD frequency, whereas neither T nor E changed significantly in females before EOD frequency increases. Saline injections caused a drop in T in the male control group and had no effect in the female control group. We presume that the effect of hCG on the electrosensory system of males is mediated via androgens. Whether the effects of hCG on females are mediated by slight increases in circulating levels of gonadal steroids, the release of hormones other than T or E, or are due to direct effects on the nervous system is not known.